Document Detail


Natriuretic peptides after pulmonary resection.
MedLine Citation:
PMID:  12022554     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Little is known about alterations in the levels and influence of natriuretic peptide (NP) on cardiopulmonary function after pulmonary resection for lung cancer. This study was designed to investigate the patterns and activity of NP after pulmonary resection. METHODS: We investigated changes in plasma A-type (atrial) NP and B-type (brain) NP (BNP) using radioimmunoassay, in lung cancer patients before and after lobectomy (n = 15) or pneumonectomy (n = 10). Patient characteristics, respiratory function, operative time, blood loss, intraoperative fluid administration, and intraoperative urine output in both groups were also compared. Pulmonary hemodynamic variables were monitored continuously. RESULTS: Plasma concentrations of A-type NP and BNP did not differ between the two groups preoperatively. However, the group undergoing pneumonectomy exhibited higher concentrations of A-type NP and BNP than the group undergoing lobectomy on postoperative days 3 and 7. Alterations in A-type NP and BNP after pulmonary resection therefore differed according to the volume of lung tissue resected. Both mean pulmonary artery pressure and total pulmonary vascular resistance increased significantly in the pneumonectomy group. The total pulmonary vascular resistance on postoperative day 3 correlated with the plasma BNP concentration in the pneumonectomy group. CONCLUSIONS: A-type NP and BNP effectively compensate for the right ventricular dysfunction noted after pulmonary resection, and this is more evident after pneumonectomy than after lobectomy. Changes in ventricular activity associated with changes in plasma BNP and total pulmonary vascular resistance are indicative of cardiopulmonary adjustments after pneumonectomy.
Authors:
Kohsuke Tayama; Shinzo Takamori; Masahiro Mitsuoka; Akihiro Hayashi; Kohichi Tamura; Hiroharu Mifune; Kazuo Shirouzu
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  73     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2002 May 
Date Detail:
Created Date:  2002-05-22     Completed Date:  2002-06-10     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1582-6     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, Kurume University School of Medicine, Japan. ktayama@kkr.sasebo.nagasaki.jp
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MeSH Terms
Descriptor/Qualifier:
Aged
Atrial Natriuretic Factor / blood*
Female
Humans
Lung / blood supply
Lung Neoplasms / blood,  surgery*
Male
Middle Aged
Natriuretic Peptide, Brain / blood*
Pneumonectomy*
Postoperative Complications / blood*
Pulmonary Wedge Pressure / physiology
Radioimmunoassay
Vascular Resistance / physiology
Chemical
Reg. No./Substance:
114471-18-0/Natriuretic Peptide, Brain; 85637-73-6/Atrial Natriuretic Factor

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